<?=$this->load->view('include_header',null)?>
<style type="text/css">
form#form textarea {
    height: 50px;
    overflow: auto;
    padding: 5px;
    width: 410px;
}
</style>
	<div id="top-panel">
		<div id="panel">
			<ul>
				<li class="current"><a href="<?=site_url('archive/idcard/'.$id)?>" class="report"><?=(empty($id))?"录入新":"编辑"?>客户基本信息</a></li>
				<?php if(!empty($info->id)):?><li><a id="printInfo" class="folder_table">打印本页信息</a></li><?php endif;?>
			</ul>
		</div>
	</div>
	<div id="wrapper">
		<div id="content">
			<div id="box">
<!-- table begin -->
<form method="post" id="form"  enctype="multipart/form-data" action="<?=site_url('schengen/au_student_update/'.$cateid)?>">

	<h3>澳大利亚学生申请表[157A]</h3>
    <table width="100%">
    <thead>
        <tr>
          <td colspan="4" align="right"><img src="<?= (@$info->avatar)?@$info->avatar:'images/avatar.gif'?>" width="150" height="150" /></td>
		  <td align="right">
		  上传照片<br />
		  <input type="file" name="userphoto" /><br />
		  (.gif|.jpg|.png文件,最大1M)<br />
		  <?php if (@$info->attachment):?><a href="<?= @$info->attachment?>" target="_blank">点击下载附件</a><?php endif; ?>
		  &nbsp;&nbsp;&nbsp;&nbsp;上传附件<br />
		  <input type="file" name="userfile" /><br />
		  (.pdf|.zip|.rar|.doc,最大2M)		  </td>
        </tr>
    </thead>
    <tfoot>
        <tr>
            <td colspan="5" align="right">			
			<input type="hidden" name="id" value="<?=$id?>" />
			<input id="button1" type="submit" value="提交信息" />
			<input id="button2" type="reset" value="重置" />			</td>
        </tr>
    </tfoot>

    <tbody>
        <tr class="odd">
            <td colspan="5"><strong>Part A – To be completed by all applicants</strong></td>
        </tr>
        <tr class="even">
            <td colspan="5"><strong>Application overview</strong></td>
        </tr>
        <tr class="odd">
            <td>1 How many people are included in this application?</td>
            <td colspan="4"><input type="text" name="txt_1" value="<?= @$info->txt_1?>" /></td>
        </tr>
        <tr class="even">
            <td>2 TYPE OF APPLICATION </td>
            <td colspan="4">
<input type="radio" name="rd_2" value="1" <?= (@$info->rd_2==1)?'checked':''?> />
Yourself as a student ▶ Complete Parts A, B and D<br />
<input type="radio" name="rd_2" value="2" <?= (@$info->rd_2==2)?'checked':''?> />
Yourself and family ▶ Complete Parts A, B and D<br />
<input type="radio" name="rd_2" value="3" <?= (@$info->rd_2==3)?'checked':''?> />
As a member of a student’s family unit ▶ Complete Parts A, B and D</td>
        </tr>
        <tr class="odd">
            <td colspan="5"><strong>Your details</strong></td>
        </tr>
        <tr class="even">
          <td>3 Your full name in English</td>
		  <td colspan="4">Family name  <input type="text" name="surname" value="<?= @$info->surname?>" /> 
		    &nbsp;&nbsp;Given names 
		    <input type="text" name="firstname" value="<?= @$info->firstname?>" /></td>
        </tr>
        <tr class="odd">
            <td>4 Name in your own language or script (if applicable)</td>
            <td colspan="4"><input type="text" name="script_name" value="<?= @$info->script_name?>" /></td>
        </tr>
        <tr class="even">
            <td>5 Have you been known by any other names?<br />
              (including name at birth, previous married names, aliases)</td>
            <td colspan="4"><input type="radio" name="rd_5" value="0" <?= (@$info->rd_5==0)?'checked':''?> />
              No<br />
              <input type="radio" name="rd_5" value="1" <?= (@$info->rd_5==1)?'checked':''?> />
              Yes  ▶ Give details and provide supporting evidence eg. birth certifi cate/marriage certifi cate<br />
              Family name 
              <input type="text" name="other_surname" value="<?= @$info->other_surname?>" />
&nbsp;&nbsp;Given names 
<input type="text" name="other_firstname" value="<?= @$info->other_firstname?>" /></td>
        </tr>
        <tr class="odd">
            <td>6 Sex</td>
            <td><input type="radio" name="sex" value="1" <?= (@$info->sex==1)?'checked':''?> />
              Male
              <input type="radio" name="sex" value="2" <?= (@$info->sex==2)?'checked':''?> />
              Female</td>
            <td>&nbsp;</td>
            <td>7 Date of birth</td>
            <td><input type="text" name="birth" value="<?= @$info->birth?>" id="birth" />
              <br />
              (DAY MONTH YEAR)</td>
        </tr>
        <tr class="even">
            <td>8 Place of birth</td>
            <td colspan="4">Town/city 
              <input type="text" name="birth_place" value="<?= @$info->birth_place?>" />
&nbsp;&nbsp;Country 
<input type="text" name="birth_country" value="<?= @$info->birth_country?>" /></td>
        </tr>
		        <tr class="odd">
            <td>9 Relationship status</td>
            <td colspan="4">
<input type="radio" name="marital_status" value="1" <?= (@$info->marital_status==1)?'checked':''?> />
Married 
<input type="radio" name="marital_status" value="2" <?= (@$info->marital_status==2)?'checked':''?> />
Engaged 
<input type="radio" name="marital_status" value="3" <?= (@$info->marital_status==3)?'checked':''?> />
De facto 
<input type="radio" name="marital_status" value="4" <?= (@$info->marital_status==4)?'checked':''?> />
Separated 
<input type="radio" name="marital_status" value="5" <?= (@$info->marital_status==5)?'checked':''?> />
Divorced 
<input type="radio" name="marital_status" value="6" <?= (@$info->marital_status==6)?'checked':''?> />
Widowed 
<br />
<input type="radio" name="marital_status" value="7" <?= (@$info->marital_status==7)?'checked':''?> />
Never married or been in a de facto relationship</td>
		        </tr>
        <tr class="even">
            <td>10 Your present country of citizenship</td>
            <td><input type="text" name="citizenship" value="<?= @$info->citizenship?>" /></td>
            <td>&nbsp;</td>
            <td>11 Do you hold any other citizenship?</td>
            <td><input type="radio" name="has_other_citizenship" value="0" <?= (@$info->has_other_citizenship==0)?'checked':''?> />
              No<br />
              <input type="radio" name="has_other_citizenship" value="1" <?= (@$info->has_other_citizenship==1)?'checked':''?> />
              Yes  ▶ Which countries?<br />
              <input type="text" name="other_citizenship" value="<?= @$info->other_citizenship?>" /></td>
        </tr>		
        <tr class="odd">
            <td>12 Do you have a passport?</td>
            <td colspan="4"><input type="radio" name="has_passport" value="0" <?= (@$info->has_passport==0)?'checked':''?> />
No<br />
<input type="radio" name="has_passport" value="1" <?= (@$info->has_passport==1)?'checked':''?> />
Yes  ▶ Details from your passport<br />
Passport number 
<input type="text" name="travel_document_num" value="<?= @$info->travel_document_num?>" />
&nbsp;&nbsp;Country of passport 
<input type="text" name="travel_document_country" value="<?= @$info->travel_document_country?>" />
<br />
Date of issue 
<input type="text" name="travel_document_issue_date" value="<?= @$info->travel_document_issue_date?>" id="travel_document_issue_date" />
&nbsp;&nbsp;Date of expiry  <input type="text" name="travel_document_valid_date" value="<?= @$info->travel_document_valid_date?>" id="travel_document_valid_date" />
（DAY MONTH YEAR）<br />
Issuing authority/Place of issue as shown in your passport 
<input name="travel_document_issue_place" type="text" value="<?= @$info->travel_document_issue_place?>" /></td>
        </tr>
        <tr class="even">
            <td colspan="2">13 Details of identity card or identity number issued to you by your government (if applicable) eg. National identity card.<br />
              Note: If you are the holder of multiple identity numbers because you are a citizen of more than one country, you need to enter the identity number on the card from the country that you live in.</td>
            <td colspan="3">Identity number 
              <input type="text" name="national_id" value="<?= @$info->national_id?>"/>
              <br />
              Country of issue 
              <input type="text" name="national_country" value="<?= @$info->national_country?>"/></td>
        </tr>
        <tr class="odd">
            <td>14 Your country of usual residence</td>
            <td colspan="4"><input type="text" name="residential_country" value="<?= @$info->residential_country?>"/></td>
        </tr>
        <tr class="even">
            <td colspan="2">15 Your residential address in your country of usual residence<br />
              Note: A post office box address is not acceptable as a residential address. Failure to give a residential address will result in your application being invalid.</td>
            <td colspan="3"><input name="address" type="text" value="<?= @$info->address?>" style="width:300px"/>
              <br />
              POSTCODE  <input type="text" name="postcode" value="<?= @$info->postcode?>"/></td>
        </tr>

        <tr class="odd">
            <td>16 Your telephone numbers outside Australia</td>
            <td colspan="4">Office hours ： COUNTRY CODE
              <input name="office_country_code" type="text" value="<?= @$info->office_country_code?>" style="width:50px"/>               
              AREA CODE
              <input name="office_area_code" type="text" value="<?= @$info->office_area_code?>" style="width:50px"/>              
               NUMBER 
              <input type="text" name="office_tel" value="<?= @$info->office_tel?>"/>
              <br />
              After hours ： COUNTRY CODE
              <input name="after_country_code" type="text" value="<?= @$info->after_country_code?>" style="width:50px"/>
AREA CODE
<input name="after_area_code" type="text" value="<?= @$info->after_area_code?>" style="width:50px"/>
NUMBER
<input type="text" name="after_tel" value="<?= @$info->after_tel?>"/></td>
        </tr>
        <tr class="even">
           <td colspan="2">17 Your residential address in Australia (if known)</td>
            <td colspan="3"><input name="au_address" type="text" value="<?= @$info->au_address?>" style="width:300px"/>
              <br />
              POSTCODE  <input type="text" name="au_postcode" value="<?= @$info->au_postcode?>"/></td>
        </tr>
        <tr class="odd">
            <td>18 Your telephone numbers in Australia (if known)</td>
            <td colspan="4">Office hours ：                
AREA CODE
<input name="au_office_areacode" type="text" value="<?= @$info->au_office_areacode?>" style="width:50px"/>            
NUMBER 
<input type="text" name="au_office_tel" value="<?= @$info->au_office_tel?>"/>
<br />
After hours ： 
AREA CODE
<input name="au_after_areacode" type="text" value="<?= @$info->au_after_areacode?>" style="width:50px"/>
NUMBER
<input type="text" name="au_after_tel" value="<?= @$info->au_after_tel?>"/></td>
        </tr>
        <tr class="even">
             <td>19 Address for correspondence</td>
            <td colspan="4"><input name="correspondence_address" type="text" value="<?= @$info->correspondence_address?>" style="width:300px"/>
				<br />
POSTCODE
<input type="text" name="correspondence_postcode" value="<?= @$info->correspondence_postcode?>"/></td>
        </tr>
        <tr class="odd">
            <td>20 Do you agree to the department communicating <br />
              with you by fax, e-mail or other electronic means?</td>
            <td colspan="4">
<input type="radio" name="rd_20" value="0" <?= (@$info->rd_20==0)?'checked':''?> />
No<br />
<input type="radio" name="rd_20" value="1" <?= (@$info->rd_20==1)?'checked':''?> />
Yes  ▶ Give details<br />
Fax number ： COUNTRY CODE
<input name="fax_country" type="text" value="<?= @$info->fax_country?>" style="width:50px"/>
AREA CODE
<input name="fax_area" type="text" value="<?= @$info->fax_area?>" style="width:50px"/>
NUMBER
<input type="text" name="fax" value="<?= @$info->fax?>"/>
<br />
E-mail address ： 
<input type="text" name="email" value="<?= @$info->email?>" id="email"/></td>
        </tr>
        <tr class="even">
            <td colspan="5">21 Give details of all members of your family unit whether or not they
			intend to accompany you to Australia.<br />
			Members of your family unit are your partner and any dependent
			children of you or your partner who are unmarried, not in a de facto
			relationship and who have not turned 18 years of age.<br />
			<br />
			1. Family name 
			<input type="text" name="member1_surname" value="<?= @$info->member1_surname?>"/>              
			Given names 
			<input type="text" name="member1_firstname" value="<?= @$info->member1_firstname?>"/>              
			Relationship to you 
			<input type="text" name="member1_relate" value="<?= @$info->member1_relate?>"/>
			<br />
			Citizenship(s) 
			<input type="text" name="member1_citizenship" value="<?= @$info->member1_citizenship?>"/>              
			Date of birth 
			<input type="text" name="member1_birth" value="<?= @$info->member1_birth?>" id="member1_birth"/>
			<br />
			Is this person included in this application? 
			<input type="radio" name="is_member1" value="0" <?= (@$info->is_member1==0)?'checked':''?> />
			No
			<input type="radio" name="is_member1" value="1" <?= (@$info->is_member1==1)?'checked':''?> />
			Yes  ▶ Details from passport<br />
			Passport number 
			<input type="text" name="member1_passport" value="<?= @$info->member1_passport?>"/> 
			Country of passport 
			<input type="text" name="member1_country" value="<?= @$info->member1_country?>"/> 
			<br />
			Date of issue 
			<input type="text" name="member1_issue" value="<?= @$info->member1_issue?>" id="member1_issue"/> 
			Date of expiry 
			<input type="text" name="member1_expiry" value="<?= @$info->member1_expiry?>" id="member1_expiry"/> 
			Issuing authority/Place of issue as shown in passport 
			<input type="text" name="member1_issue_place" value="<?= @$info->member1_issue_place?>"/>
			<br />
			Does this person intend to study in Australia for more than 3 months? 
			<input type="radio" name="is_member1_study" value="0" <?= (@$info->is_member1_study==0)?'checked':''?> />
			No
			<input type="radio" name="is_member1_study" value="1" <?= (@$info->is_member1_study==1)?'checked':''?> />
			Yes <br />
			<br />
			2. Family name 
			<input type="text" name="member2_surname" value="<?= @$info->member2_surname?>"/>              
			Given names 
			<input type="text" name="member2_firstname" value="<?= @$info->member2_firstname?>"/>              
			Relationship to you 
			<input type="text" name="member2_relate" value="<?= @$info->member2_relate?>"/>
			<br />
			Citizenship(s) 
			<input type="text" name="member2_citizenship" value="<?= @$info->member2_citizenship?>"/>              
			Date of birth 
			<input type="text" name="member2_birth" value="<?= @$info->member2_birth?>" id="member2_birth"/>
			<br />
			Is this person included in this application? 
			<input type="radio" name="is_member2" value="0" <?= (@$info->is_member2==0)?'checked':''?> />
			No
			<input type="radio" name="is_member2" value="1" <?= (@$info->is_member2==1)?'checked':''?> />
			Yes  ▶ Details from passport<br />
			Passport number 
			<input type="text" name="member2_passport" value="<?= @$info->member2_passport?>"/> 
			Country of passport 
			<input type="text" name="member2_country" value="<?= @$info->member2_country?>"/> 
			<br />
			Date of issue 
			<input type="text" name="member2_issue" value="<?= @$info->member2_issue?>" id="member2_issue"/> 
			Date of expiry 
			<input type="text" name="member2_expiry" value="<?= @$info->member2_expiry?>" id="member2_expiry"/> 
			Issuing authority/Place of issue as shown in passport 
			<input type="text" name="member2_issue_place" value="<?= @$info->member2_issue_place?>"/>
			<br />
			Does this person intend to study in Australia for more than 3 months? 
			<input type="radio" name="is_member2_study" value="0" <?= (@$info->is_member2_study==0)?'checked':''?> />
			No
			<input type="radio" name="is_member2_study" value="1" <?= (@$info->is_member2_study==1)?'checked':''?> />
			Yes <br />
			<br />
			3. Family name 
			<input type="text" name="member3_surname" value="<?= @$info->member3_surname?>"/>              
			Given names 
			<input type="text" name="member3_firstname" value="<?= @$info->member3_firstname?>"/>              
			Relationship to you 
			<input type="text" name="member3_relate" value="<?= @$info->member3_relate?>"/>
			<br />
			Citizenship(s) 
			<input type="text" name="member3_citizenship" value="<?= @$info->member3_citizenship?>"/>              
			Date of birth 
			<input type="text" name="member3_birth" value="<?= @$info->member3_birth?>" id="member3_birth"/>
			<br />
			Is this person included in this application? 
			<input type="radio" name="is_member3" value="0" <?= (@$info->is_member3==0)?'checked':''?> />
			No
			<input type="radio" name="is_member3" value="1" <?= (@$info->is_member3==1)?'checked':''?> />
			Yes  ▶ Details from passport<br />
			Passport number 
			<input type="text" name="member3_passport" value="<?= @$info->member3_passport?>"/> 
			Country of passport 
			<input type="text" name="member3_country" value="<?= @$info->member3_country?>"/> 
			<br />
			Date of issue 
			<input type="text" name="member3_issue" value="<?= @$info->member3_issue?>" id="member3_issue"/> 
			Date of expiry 
			<input type="text" name="member3_expiry" value="<?= @$info->member3_expiry?>" id="member3_expiry"/> 
			Issuing authority/Place of issue as shown in passport 
			<input type="text" name="member3_issue_place" value="<?= @$info->member3_issue_place?>"/>
			<br />
			Does this person intend to study in Australia for more than 3 months? 
			<input type="radio" name="is_member3_study" value="0" <?= (@$info->is_member3_study==0)?'checked':''?> />
			No
			<input type="radio" name="is_member3_study" value="1" <?= (@$info->is_member3_study==1)?'checked':''?> />
			Yes <br /></td>
        </tr>
        <tr class="odd">
            <td colspan="2">22 Have any school age dependants (that is, those who have turned 5 but
              who have not yet turned 18 years of age) included in this application
              been enrolled in a school in Australia?</td>
			<td colspan="3">
<input type="radio" name="rd_22" value="2" <?= (@$info->rd_22==2)?'checked':''?> />
Not applicable<br />
<input type="radio" name="rd_22" value="0" <?= (@$info->rd_22==0)?'checked':''?> />
No<br />
<input type="radio" name="rd_22" value="1" <?= (@$info->rd_22==1)?'checked':''?> />
Yes  ▶ You must provide evidence (eg. enrolment advice,offer letter)</td>
        </tr>
        <tr class="even">
            <td colspan="2">23 Do you have the sole legal right to determine where any dependants
              under 18 years of age who are included in this application will live or to
              remove each such dependant from their country of usual residence?</td>
            <td colspan="3">
<input type="radio" name="rd_23" value="0" <?= (@$info->rd_23==0)?'checked':''?> />
No  ▶ Give details below<br />
<input type="radio" name="rd_23" value="1" <?= (@$info->rd_23==1)?'checked':''?> />
Yes  ▶ Go to Question 24</td>
        </tr>
        <tr class="odd">
            <td colspan="5">Give details of ALL other people not included in this application who have custody, access or guardianship rights in relation to the dependant(s).<br />
              Attach a statutory declaration from each of these people giving permission for the dependant to accompany you to Australia.<br />
              <br />
	1. Family name
	<input type="text" name="dependant1_surname" value="<?= @$info->dependant1_surname?>"/>
	Given names
	<input type="text" name="dependant1_firstname" value="<?= @$info->dependant1_firstname?>"/><br />
	Residential address 
	<input name="dependant1_address" type="text" value="<?= @$info->dependant1_address?>" style="width:300px"/> 
	POSTCODE 
	<input type="text" name="dependant1_postcode" value="<?= @$info->dependant1_postcode?>"/>
	<br />
	Telephone : COUNTRY CODE
	<input name="dependant1_countrycode" type="text" value="<?= @$info->dependant1_countrycode?>" style="width:50px"/>
	AREA CODE
	<input name="dependant1_areacode" type="text" value="<?= @$info->dependant1_areacode?>" style="width:50px"/>
	NUMBER
	<input type="text" name="dependant1_tel" value="<?= @$info->dependant1_tel?>"/>
	<br />
	Relationship to dependant 
	<input type="text" name="dependant1_ralate" value="<?= @$info->dependant1_ralate?>"/> 
	Nature of legal right 
	<input type="text" name="dependant1_right" value="<?= @$info->dependant1_right?>"/><br />
	Statutory declaration attached?
	<input type="radio" name="is_dependant1_attach" value="0" <?= (@$info->is_dependant1_attach==0)?'checked':''?> />No
	<input type="radio" name="is_dependant1_attach" value="1" <?= (@$info->is_dependant1_attach==1)?'checked':''?> />Yes<br />
<br />
	2. Family name
	<input type="text" name="dependant2_surname" value="<?= @$info->dependant2_surname?>"/>
	Given names
	<input type="text" name="dependant2_firstname" value="<?= @$info->dependant2_firstname?>"/><br />
	Residential address 
	<input name="dependant2_address" type="text" value="<?= @$info->dependant2_address?>" style="width:300px"/> 
	POSTCODE 
	<input type="text" name="dependant2_postcode" value="<?= @$info->dependant2_postcode?>"/>
	<br />
	Telephone : COUNTRY CODE
	<input name="dependant2_countrycode" type="text" value="<?= @$info->dependant2_countrycode?>" style="width:50px"/>
	AREA CODE
	<input name="dependant2_areacode" type="text" value="<?= @$info->dependant2_areacode?>" style="width:50px"/>
	NUMBER
	<input type="text" name="dependant2_tel" value="<?= @$info->dependant2_tel?>"/>
	<br />
	Relationship to dependant 
	<input type="text" name="dependant2_ralate" value="<?= @$info->dependant2_ralate?>"/> 
	Nature of legal right 
	<input type="text" name="dependant2_right" value="<?= @$info->dependant2_right?>"/><br />
	Statutory declaration attached?
	<input type="radio" name="is_dependant2_attach" value="0" <?= (@$info->is_dependant2_attach==0)?'checked':''?> />No
	<input type="radio" name="is_dependant2_attach" value="1" <?= (@$info->is_dependant2_attach==1)?'checked':''?> />Yes<br />
		</td>
        </tr>
        <tr class="even">
            <td colspan="2">24 Are any of your dependants who are under 18 years of age, and who
              are included in this application, the subject of a court order giving you:
              <br />
              • the sole legal right to determine where they will live; or<br />
              • the right to remove them from their country of usual residence?</td>
            <td colspan="3">
<input type="radio" name="rd_24" value="2" <?= (@$info->rd_24==2)?'checked':''?> />
Not applicable<br />
<input type="radio" name="rd_24" value="0" <?= (@$info->rd_24==0)?'checked':''?> />
No<br />
<input type="radio" name="rd_24" value="1" <?= (@$info->rd_24==1)?'checked':''?> />
Yes  ▶ Attach a certified copy of the court order(s)</td>
        </tr>
        <tr class="odd">
            <td colspan="5"><strong>Previous visa applications</strong><br />
              <br />
              WARNING: In general, a person can only hold one visa at a time. If you are granted a visa while you already have another, the first visa will cease automatically when the new visa is granted.</td>
        </tr>
        <tr class="even">
            <td colspan="5">25 Have you or any other person included in this application previously applied for any type of Australian visa? 
<input type="radio" name="rd_25_1" value="0" <?= (@$info->rd_25_1==0)?'checked':''?> />
No
<input type="radio" name="rd_25_1" value="1" <?= (@$info->rd_25_1==1)?'checked':''?> />
Yes<br />
Do you currently hold a visa?  
<input type="radio" name="rd_25_2" value="0" <?= (@$info->rd_25_2==0)?'checked':''?> />
No
<input type="radio" name="rd_25_2" value="1" <?= (@$info->rd_25_2==1)?'checked':''?> />
Yes<br />
Are you currently awaiting a decision on another visa application?   
<input type="radio" name="rd_25_3" value="0" <?= (@$info->rd_25_3==0)?'checked':''?> />
No
<input type="radio" name="rd_25_3" value="1" <?= (@$info->rd_25_3==1)?'checked':''?> />
Yes<br />
If you answered ‘Yes’ to any of the above questions, give details below<br />
<br />
1. Name 
<input type="text" name="pre1_name" value="<?= @$info->pre1_name?>"/> 
Type of visa 
<input type="text" name="pre1_type" value="<?= @$info->pre1_type?>"/> 
Place of issue 
<input type="text" name="pre1_place" value="<?= @$info->pre1_place?>"/> 
<br />
Date of issue 
<input type="text" name="pre1_date" value="<?= @$info->pre1_date?>" id="pre1_date"/> 
(DAY MONTH YEAR) <br />
Application 
<input type="radio" name="is_pre1" value="1" <?= (@$info->is_pre1==1)?'checked':''?> />
Refused 
<input type="radio" name="is_pre1" value="2" <?= (@$info->is_pre1==2)?'checked':''?> />
Granted ▶ Visa label number 
<input type="text" name="pre1_label" value="<?= @$info->pre1_label?>"/> 
If granted a visa without a label, provide the 13-digit visa grant number (as shown on the letter notifying you of visa grant).
<input type="text" name="pre1_num" value="<?= @$info->pre1_num?>"/>
<br />
 <br />
 2. Name
<input type="text" name="pre2_name" value="<?= @$info->pre2_name?>"/> 
Type of visa 
<input type="text" name="pre2_type" value="<?= @$info->pre2_type?>"/> 
Place of issue 
<input type="text" name="pre2_place" value="<?= @$info->pre2_place?>"/> 
<br />
Date of issue 
<input type="text" name="pre2_date" value="<?= @$info->pre2_date?>" id="pre2_date"/> 
(DAY MONTH YEAR) <br />
Application 
<input type="radio" name="is_pre2" value="1" <?= (@$info->is_pre2==1)?'checked':''?> />
Refused 
<input type="radio" name="is_pre2" value="2" <?= (@$info->is_pre2==2)?'checked':''?> />
Granted ▶ Visa label number 
<input type="text" name="pre2_label" value="<?= @$info->pre2_label?>"/> 
If granted a visa without a label, provide the 13-digit visa grant number (as shown on the letter notifying you of visa grant).
<input type="text" name="pre2_num" value="<?= @$info->pre2_num?>"/>
<br />
		</td>
        </tr>
        <tr class="odd">
            <td>26 If you are applying:</td>
            <td colspan="4"><input type="radio" name="rd_26" value="1" <?= (@$info->rd_26==1)?'checked':''?> /> 
              as a member of the family unit of a student▶ Go to Part C<br />
              <input type="radio" name="rd_26" value="2" <?= (@$info->rd_26==2)?'checked':''?> />
              in all other cases ▶ Go to Part B</td>
        </tr>
        <tr class="even">
             <td>27 Are you applying in Australia?</td>
             <td colspan="4"><input type="radio" name="rd_27" value="0" <?= (@$info->rd_27==0)?'checked':''?> />
               No ▶ Go to Question 28<br />
              <input type="radio" name="rd_27" value="1" <?= (@$info->rd_27==1)?'checked':''?> />
              Yes ▶ Go to Question 29</td>
        </tr>
        <tr class="odd">
            <td>28 What date do you expect to arrive in Australia?</td>
            <td><input type="text" name="txt_28" value="<?= @$info->txt_28?>" id="txt_28"/>
              <br />
              (DAY MONTH YEAR)</td>
            <td>&nbsp;</td>
            <td>29 What date do you intend to depart Australia after completing your course?</td>
            <td><input type="text" name="txt_29" value="<?= @$info->txt_29?>" id="txt_29"/>
              <br />
(DAY MONTH YEAR)</td>
        </tr>
        <tr class="even">
            <td>30 Do you currently hold a student visa?</td>
            <td colspan="4">
			<input type="radio" name="rd_30" value="0" <?= (@$info->rd_30==0)?'checked':''?> />
              No  ▶ If you are in Assessment Level 2, 3, 4 or 5 you will be required at Question 44 to provide exceptional reasons why you should be granted a student visa in Australia.<br />
              <input type="radio" name="rd_30" value="1" <?= (@$info->rd_30==1)?'checked':''?> />
              Yes</td>
           
        </tr>
        <tr class="odd">
            <td colspan="5">31 Provide details of your highest qualification obtained outside Australia, as well as all other studies and training obtained outside Australia.<br />
              You must provide evidence of your study and training, including academic records, if you are:<br />
              • in Assessment Level 3, 4 or 5; or<br />
              • in Assessment Level 2 seeking to undertake studies in the postgraduate research sector.<br />
              All other applicants may be requested to provide evidence where considered necessary.<br />
              In certain limited circumstances, you may be requested to provide copies of any published works written by you.<br />
              <br />
              1. Highest qualification 
              <input type="text" name="qualification1_name" value="<?= @$info->qualification1_name?>"/>              
               Name of education provider or training body 
              <input name="qualification1_edu" type="text" value="<?= @$info->qualification1_edu?>" />
              <br />
              Address of education provider or training body 
              <input name="qualification1_address" type="text" value="<?= @$info->qualification1_address?>" style="width:300px"/>              
               POSTCODE 
              <input type="text" name="qualification1_postcode" value="<?= @$info->qualification1_postcode?>" style="width:50px"/>
              <br />
              Commencement date 
              <input type="text" name="qualification1_startdate" value="<?= @$info->qualification1_startdate?>" id="qualification1_startdate"/>              
               Finish date 
               <input type="text" name="qualification1_enddate" value="<?= @$info->qualification1_enddate?>" id="qualification1_enddate"/>
              (DAY MONTH YEAR) <br />
              Documentation attached? 
              <input type="radio" name="is_qualification1" value="0" <?= (@$info->is_qualification1==0)?'checked':''?> />
              No 
              <input type="radio" name="is_qualification1" value="1" <?= (@$info->is_qualification1==1)?'checked':''?> />
Yes <br />
<br />
2. Other course undertaken outside Australia 
              <input type="text" name="qualification2_name" value="<?= @$info->qualification2_name?>"/>
Name of education provider or training body
<input name="qualification2_edu" type="text" value="<?= @$info->qualification2_edu?>"/>
<br />
Address of education provider or training body
<input name="qualification2_address" type="text" value="<?= @$info->qualification2_address?>"  style="width:300px"/>
POSTCODE
<input type="text" name="qualification2_postcode" value="<?= @$info->qualification2_postcode?>" style="width:50px"/>
<br />
Commencement date
<input type="text" name="qualification2_startdate" value="<?= @$info->qualification2_startdate?>" id="qualification2_startdate"/>
Finish date
<input type="text" name="qualification2_enddate" value="<?= @$info->qualification2_enddate?>" id="qualification2_enddate"/>
(DAY MONTH YEAR) <br />
Documentation attached?
<input type="radio" name="is_qualification2" value="0" <?= (@$info->is_qualification2==0)?'checked':''?> />
No
<input type="radio" name="is_qualification2" value="1" <?= (@$info->is_qualification2==1)?'checked':''?> />
Yes <br />
<br />
3. Other course undertaken outside Australia
<input type="text" name="qualification3_name" value="<?= @$info->qualification3_name?>"/>
Name of education provider or training body
<input name="qualification3_edu" type="text" value="<?= @$info->qualification3_edu?>" />
<br />
Address of education provider or training body
<input name="qualification3_address" type="text" value="<?= @$info->qualification3_address?>" style="width:300px"/>
POSTCODE
<input type="text" name="qualification3_postcode" value="<?= @$info->qualification3_postcode?>" style="width:50px"/>
<br />
Commencement date
<input type="text" name="qualification3_startdate" value="<?= @$info->qualification3_startdate?>" id="qualification3_startdate"/>
Finish date
<input type="text" name="qualification3_enddate" value="<?= @$info->qualification3_enddate?>" id="qualification3_enddate"/>
(DAY MONTH YEAR) <br />
Documentation attached?
<input type="radio" name="is_qualification3" value="0" <?= (@$info->is_qualification3==0)?'checked':''?> />
No
<input type="radio" name="is_qualification3" value="1" <?= (@$info->is_qualification3==1)?'checked':''?> />
Yes </td>
        </tr>
        <tr class="even">
		    <td colspan="5">32 Have you previously studied in Australia?
<input type="radio" name="rd_32" value="0" <?= (@$info->rd_32==0)?'checked':''?> />No
<input type="radio" name="rd_32" value="1" <?= (@$info->rd_32==1)?'checked':''?> />Yes  ▶ Give details below<br />
You must provide evidence of your studies and training, including academic records<br />
1. Previous course in Australia 
<input type="text" name="study1_course" value="<?= @$info->study1_course?>"/> 
Name of education provider or training body 
<input name="study1_edu" type="text" value="<?= @$info->study1_edu?>" />
<br />
Period of study : From 
<input type="text" name="study1_from" value="<?= @$info->study1_from?>"/>
(MONTH YEAR)  
to 
<input type="text" name="study1_to" value="<?= @$info->study1_to?>"/> 
(MONTH YEAR) <br />
<br />
2. Previous course in Australia
<input type="text" name="study2_course" value="<?= @$info->study2_course?>"/>
Name of education provider or training body
<input name="study2_edu" type="text" value="<?= @$info->study2_edu?>" />
<br />
Period of study : From
<input type="text" name="study2_from" value="<?= @$info->study2_from?>"/>
(MONTH YEAR)  
to
<input type="text" name="study2_to" value="<?= @$info->study2_to?>"/>
(MONTH YEAR) <br />
<br />
3. Previous course in Australia
<input type="text" name="study3_course" value="<?= @$info->study3_course?>"/>
Name of education provider or training body
<input name="study3_edu" type="text" value="<?= @$info->study3_edu?>" />
<br />
Period of study : From
<input type="text" name="study3_from" value="<?= @$info->study3_from?>"/>
(MONTH YEAR)  
to
<input type="text" name="study3_to" value="<?= @$info->study3_to?>"/>
(MONTH YEAR) </td>
        </tr>
        <tr class="odd">
            <td colspan="5">33 Give details of your intended courses of study in Australia.<br />
              You must provide evidence of enrolment (an electronic confirmation of enrolment) or a letter of offer of a place in a course unless you are seeking to study in Australia as a secondary school exchange student or as a student sponsored by AusAID or the Australian Department of Defence.<br />
              If you are seeking to study as an exchange student, you must attach to this application the Acceptance Advice Secondary Exchange Student (AASES) form as evidence of enrolment.<br />
              If you wish to study in Australia as a student sponsored by AusAID or the Australian Department of Defence, you must attach evidence of sponsorship from AusAID or the Department of Defence.<br />
              <br />              
              1.Intended course 
              <input type="text" name="intended1_course" value="<?= @$info->intended1_course?>"/>              
               Name of education provider or training body 
              <input name="intended1_edu" type="text" value="<?= @$info->intended1_edu?>" />
              <br />
              Commencement date 
              <input type="text" name="intended1_from" value="<?= @$info->intended1_from?>" id="intended1_from"/>              
               (DAY MONTH YEAR) Finish date 
               <input type="text" name="intended1_to" value="<?= @$info->intended1_to?>" id="intended1_to"/>
(DAY MONTH YEAR) <br />
Have you enrolled? 
<input type="radio" name="is_intended1_enroll" value="0" <?= (@$info->is_intended1_enroll==0)?'checked':''?> />
No
▶ Attach letter of ‘offer of a place in a course’
<input type="radio" name="is_intended1_enroll" value="1" <?= (@$info->is_intended1_enroll==1)?'checked':''?> />
Yes  ▶ Is evidence of enrolment attached? 
<input type="radio" name="is_intended1_attach" value="0" <?= (@$info->is_intended1_attach==0)?'checked':''?> />
No 
<input type="radio" name="is_intended1_attach" value="1" <?= (@$info->is_intended1_attach==1)?'checked':''?> />
Yes <br />
<br />
2.Intended course
<input type="text" name="intended2_course" value="<?= @$info->intended2_course?>"/>
Name of education provider or training body
<input name="intended2_edu" type="text" value="<?= @$info->intended2_edu?>" />
<br />
Commencement date
<input type="text" name="intended2_from" value="<?= @$info->intended2_from?>" id="intended2_from"/>
(DAY MONTH YEAR) Finish date
<input type="text" name="intended2_to" value="<?= @$info->intended2_to?>" id="intended2_to"/>
(DAY MONTH YEAR) <br />
Have you enrolled?
<input type="radio" name="is_intended2_enroll" value="0" <?= (@$info->is_intended2_enroll==0)?'checked':''?> />
No
▶ Attach letter of ‘offer of a place in a course’
<input type="radio" name="is_intended2_enroll" value="1" <?= (@$info->is_intended2_enroll==1)?'checked':''?> />
Yes  ▶ Is evidence of enrolment attached?
<input type="radio" name="is_intended2_attach" value="0" <?= (@$info->is_intended2_attach==0)?'checked':''?> />
No
<input type="radio" name="is_intended2_attach" value="1" <?= (@$info->is_intended2_attach==1)?'checked':''?> />
Yes <br />
<br />
3.Intended course
<input type="text" name="intended3_course" value="<?= @$info->intended3_course?>"/>
Name of education provider or training body
<input name="intended3_edu" type="text" value="<?= @$info->intended3_edu?>"/>
<br />
Commencement date
<input type="text" name="intended3_from" value="<?= @$info->intended3_from?>" id="intended3_from"/>
(DAY MONTH YEAR) Finish date
<input type="text" name="intended3_to" value="<?= @$info->intended3_to?>" id="intended3_to"/>
(DAY MONTH YEAR) <br />
Have you enrolled?
<input type="radio" name="is_intended3_enroll" value="0" <?= (@$info->is_intended3_enroll==0)?'checked':''?> />
No
▶ Attach letter of ‘offer of a place in a course’
<input type="radio" name="is_intended3_enroll" value="1" <?= (@$info->is_intended3_enroll==1)?'checked':''?> />
Yes  ▶ Is evidence of enrolment attached?
<input type="radio" name="is_intended3_attach" value="0" <?= (@$info->is_intended3_attach==0)?'checked':''?> />
No
<input type="radio" name="is_intended3_attach" value="1" <?= (@$info->is_intended3_attach==1)?'checked':''?> />
Yes <br />
<br />
Note: If you are enrolled in more than 3 courses you must attach evidence of these additional courses with your application.</td>
        </tr>
		
		<tr class="even">
            <td colspan="5"><strong>Your English language details</strong></td>
		</tr>
		
		<tr class="odd">
            <td colspan="2">34 Are you an applicant in Assessment Level 1 or 2?</td>
			<td colspan="3">
<input type="radio" name="rd_34" value="0" <?= (@$info->rd_34==0)?'checked':''?> />No 
<input type="radio" name="rd_34" value="1" <?= (@$info->rd_34==1)?'checked':''?> />Yes ▶ Go to Question 37</td>
		</tr>
		
		<tr class="even">
            <td colspan="2">35 Have you undertaken an English language proficiency test <br />
              within the last 24 months?</td>
			<td colspan="3">
<input type="radio" name="rd_35" value="0" <?= (@$info->rd_35==0)?'checked':''?> />No 
<input type="radio" name="rd_35" value="1" <?= (@$info->rd_35==1)?'checked':''?> />Yes ▶ Name of test 
<input type="text" name="txt_35_1" value="<?= @$info->txt_35_1?>"/>
<br />
Date of test 
<input type="text" name="txt_35_2" value="<?= @$info->txt_35_2?>" id="txt_35_2"/> 
(
DAY MONTH YEAR)<br />
Test certificate number 
<input type="text" name="txt_35_3" value="<?= @$info->txt_35_3?>"/></td>
		</tr>
		
		<tr class="odd">
            <td colspan="2">36 Have you studied for at least 5 years (in the English language) in one or more of the following countries:<br />
                <table width="80%">
                  <tr>
                    <td>• Australia;</td>
                    <td>• the Republic of Ireland;</td>
                  </tr>
                  <tr>
                    <td>• Canada;</td>
                    <td>• the United Kingdom; or</td>
                  </tr>
                  <tr>
                    <td>• New Zealand;</td>
                    <td>• the United States of America?</td>
                  </tr>
                  <tr>
                    <td>• South Africa;</td>
                    <td>&nbsp;</td>
                  </tr>
                </table>
              </td>
				<td colspan="3">
<input type="radio" name="rd_36" value="0" <?= (@$info->rd_36==0)?'checked':''?> />No <br />
<input type="radio" name="rd_36" value="1" <?= (@$info->rd_36==1)?'checked':''?> />Yes ▶ Attach evidence</td>
		</tr>
		
		<tr class="even">
            <td colspan="5"><strong>Your employment details</strong></td>
		</tr>
		
		<tr class="odd">
            <td colspan="5">37 Give details of your employment history since leaving school/college/university.<br />
			1. Period: From 
			<input type="text" name="employ1_from" value="<?= @$info->employ1_from?>"/> 
			(MONTH YEAR) to 
			<input type="text" name="employ1_to" value="<?= @$info->employ1_to?>"/>
			(MONTH YEAR)<br />
			Name and address of employer 
			<input name="employ1_address" type="text" value="<?= @$info->employ1_address?>" style="width:300px"/> 
			POSTCODE 
			<input type="text" name="employ1_postcode" value="<?= @$info->employ1_postcode?>" style="width:50px"/>
			<br />
			Type of business 
			<input type="text" name="employ1_business" value="<?= @$info->employ1_business?>"/> 
			Occupation 
			<input type="text" name="employ1_occupation" value="<?= @$info->employ1_occupation?>"/> 
			Salary level 
			<input type="text" name="employ1_salary" value="<?= @$info->employ1_salary?>"/> 
			<br />
			Documentation attached? 
			<input type="radio" name="is_employ1" value="0" <?= (@$info->is_employ1==0)?'checked':''?> />
			No 
			<input type="radio" name="is_employ1" value="1" <?= (@$info->is_employ1==1)?'checked':''?> />
			Yes <br />
<br />
			2. Period: From 
			<input type="text" name="employ2_from" value="<?= @$info->employ2_from?>"/> 
			(MONTH YEAR) to 
			<input type="text" name="employ2_to" value="<?= @$info->employ2_to?>"/>
			(MONTH YEAR)<br />
			Name and address of employer 
			<input name="employ2_address" type="text" value="<?= @$info->employ2_address?>" style="width:300px"/> 
			POSTCODE 
			<input type="text" name="employ2_postcode" value="<?= @$info->employ2_postcode?>" style="width:50px"/>
			<br />
			Type of business 
			<input type="text" name="employ2_business" value="<?= @$info->employ2_business?>"/> 
			Occupation 
			<input type="text" name="employ2_occupation" value="<?= @$info->employ2_occupation?>"/> 
			Salary level 
			<input type="text" name="employ2_salary" value="<?= @$info->employ2_salary?>"/> 
			<br />
			Documentation attached? 
			<input type="radio" name="is_employ2" value="0" <?= (@$info->is_employ2==0)?'checked':''?> />
			No 
			<input type="radio" name="is_employ2" value="1" <?= (@$info->is_employ2==1)?'checked':''?> />
			Yes 
		</td>
		</tr>
		
		<tr class="even">
            <td colspan="5">38 Are you currently employed? 
              <br />
              <table width="100%">
                <tr>
                  <td width="15%">
<input type="radio" name="rd_38" value="0" <?= (@$info->rd_38==0)?'checked':''?> />
No  ▶ Are you</td>
                  <td width="85%">
<input type="radio" name="rd_38_1" value="1" <?= (@$info->rd_38_1==1)?'checked':''?> />
a student
<input type="radio" name="rd_38_1" value="2" <?= (@$info->rd_38_1==2)?'checked':''?> />
unemployed
<input type="radio" name="rd_38_1" value="3" <?= (@$info->rd_38_1==3)?'checked':''?> />
other ▶ Please describe
<input type="text" name="txt_38_1" value="<?= @$info->txt_38_1?>"/>
<br />
Why do you wish to undertake the course of study you have nominated? If insufficient space, attach additional details. <br />
<textarea name="txt_38_2"><?= @$info->txt_38_2?></textarea>
▶▶Now go to Question 40</td>
                  
                </tr>
                <tr>
                  <td><input type="radio" name="rd_38" value="1" <?= (@$info->rd_38==1)?'checked':''?> />
Yes  ▶ </td>
                  <td>Your position
                    <input name="txt_38_3" type="text" value="<?= @$info->txt_38_3?>" style="width:300px"/>
                    <br />
Name and address of your employer <br />
<textarea name="txt_38_4"><?= @$info->txt_38_4?></textarea><br />
                    POSTCODE
                    <input type="text" name="txt_38_5" value="<?= @$info->txt_38_5?>"/>
                    <br />
                    Telephone number : COUNTRY CODE 
                    <input name="txt_38_6" type="text" value="<?= @$info->txt_38_6?>" style="width:50px"/>                    
                     AREA CODE 
                    <input name="txt_38_7" type="text" value="<?= @$info->txt_38_7?>" style="width:50px"/>                    
                     NUMBER 
                    <input type="text" name="txt_38_8" value="<?= @$info->txt_38_8?>"/>
                    <br />
                    Have you attached evidence of your employment details? 
                    <input type="radio" name="rd_38_9" value="0" <?= (@$info->rd_38_9==0)?'checked':''?> />
                    No 
                    <input type="radio" name="rd_38_9" value="1" <?= (@$info->rd_38_9==1)?'checked':''?> />
Yes<br />
Are you currently a student in Australia? 
<input type="radio" name="rd_38_10" value="0" <?= (@$info->rd_38_10==0)?'checked':''?> />
No
<input type="radio" name="rd_38_10" value="1" <?= (@$info->rd_38_10==1)?'checked':''?> />
Yes</td>
                 
                </tr>
              </table>
              </td>
		</tr>
		
		<tr class="odd">
            <td colspan="5">39 Have you been offered a job for when you return home at the completion of your course?<br />
			   <table width="100%">
                <tr>
                  <td width="15%"><input type="radio" name="rd_39" value="0" <?= (@$info->sex==0)?'checked':''?> />
No  ▶ </td>
                  <td width="85%">What kind of employment will you be seeking on your return to your home country?<br />
                    <textarea name="txt_39_1" ><?= @$info->txt_39_1?></textarea></td>
                </tr>
                <tr>
                  <td><input type="radio" name="rd_39" value="1" <?= (@$info->rd_39==1)?'checked':''?> />
Yes  ▶ </td>
                  <td>Name and address of your employer 
                    <textarea name="txt_39_2" ><?= @$info->txt_39_2?></textarea><br />                   
                     POSTCODE 
                    <input type="text" name="txt_39_3" value="<?= @$info->txt_39_3?>"/>
                    <br />
                    Telephone number : COUNTRY CODE
                    <input name="txt_39_4" type="text" value="<?= @$info->txt_39_4?>" style="width:50px"/>
AREA CODE
<input name="txt_39_5" type="text" value="<?= @$info->txt_39_5?>"  style="width:50px"/>
NUMBER
<input type="text" name="txt_39_6" value="<?= @$info->txt_39_6?>"/>
<br />
Title of position offered 
<input name="txt_39_7" type="text" value="<?= @$info->txt_39_7?>" style="width:300px"/></td>
                 
                </tr>
              </table>
			
			</td>
		
		</tr>
		
		<tr class="even">
            <td colspan="5"><strong>Other address details</strong></td>
		</tr>
		
		<tr class="odd">
            <td colspan="5">40 Give details of any immediate relatives in Australia (ie. parent, partner,child, brother or sister)<br />
              1. Name 
              <input type="text" name="relative1_name" value="<?= @$info->relative1_name?>"/>              
               <br />
               Relationship to you 
              <input type="text" name="relative1_relate" value="<?= @$info->relative1_relate?>"/>              
               Date of birth 
              <input type="text" name="relative1_birth" value="<?= @$info->relative1_birth?>" id="relative1_birth"/> 
              (DAY MONTH YEAR) <br />
              Address 
              <input name="relative1_address" type="text" value="<?= @$info->relative1_address?>" style="width:300px"/>
              POSTCODE
              <input type="text" name="relative1_postcode" value="<?= @$info->relative1_postcode?>" style="width:50px"/>
              <br />
              Immigration status in Australia (eg. temporary or permanent resident, Australian citizen) 
              <input type="text" name="relative1_status" value="<?= @$info->relative1_status?>"/>              
               <br />
               Date of arrival 
              <input type="text" name="relative1_arrival_date" value="<?= @$info->relative1_arrival_date?>" id="relative1_arrival_date"/>              
               (DAY MONTH YEAR)<br />
              <br />
              2. Name 
              <input type="text" name="relative2_name" value="<?= @$info->relative2_name?>"/>              
               <br />
               Relationship to you 
              <input type="text" name="relative2_relate" value="<?= @$info->relative2_relate?>"/>              
               Date of birth 
              <input type="text" name="relative2_birth" value="<?= @$info->relative2_birth?>" id="relative2_birth"/> 
              (DAY MONTH YEAR) <br />
              Address 
              <input name="relative2_address" type="text" value="<?= @$info->relative2_address?>" style="width:300px"/>
              POSTCODE
              <input type="text" name="relative2_postcode" value="<?= @$info->relative2_postcode?>" style="width:50px"/>
              <br />
              Immigration status in Australia (eg. temporary or permanent resident, Australian citizen) 
              <input type="text" name="relative2_status" value="<?= @$info->relative2_status?>"/>              
               <br />
               Date of arrival 
              <input type="text" name="relative2_arrival_date" value="<?= @$info->relative2_arrival_date?>" id="relative2_arrival_date"/>              
               (DAY MONTH YEAR)<br /></td>
		</tr>
		
		<tr class="even">
            <td colspan="5">41 Give details of your closest relative in your home country who is neither accompanying nor joining you in Australia<br />
              Name 
              <input type="text" name="txt_41_1" value="<?= @$info->txt_41_1?>"/>              
               Relationship to you 
              <input type="text" name="txt_41_2" value="<?= @$info->txt_41_2?>"/>
              <br />
              Address
              <input name="txt_41_3" type="text" value="<?= @$info->txt_41_3?>" style="width:300px"/>
POSTCODE
<input type="text" name="txt_41_4" value="<?= @$info->txt_41_4?>" style="width:50px"/>
<br />
Telephone number : COUNTRY CODE
<input name="txt_41_5" type="text" value="<?= @$info->txt_41_5?>" style="width:50px"/>
AREA CODE
<input name="txt_41_6" type="text" value="<?= @$info->txt_41_6?>" style="width:50px"/>
NUMBER
<input type="text" name="txt_41_7" value="<?= @$info->txt_41_7?>"/></td>
		</tr>
		
		<tr class="odd">
            <td colspan="5"><strong>Financial details</strong></td>
		</tr>
		
		<tr class="even">
            <td colspan="2">42 Are you applying to study in Australia as a secondary school exchange student?</td>
			<td colspan="3">
  <input type="radio" name="rd_42" value="0" <?= (@$info->rd_42==0)?'checked':''?> />No
  <input type="radio" name="rd_42" value="1" <?= (@$info->rd_42==1)?'checked':''?> />Yes   ▶ Go to Question 44</td>
		</tr>
		
		<tr class="odd">
		    <td colspan="5" valign="top">43 Do you have access to sufficient funds to support you and your family unit members for the TOTAL period of your stay in Australia (including proposed course fees for you and any school-age family members, living costs and travel costs, regardless of whether your dependants intend to accompany you to Australia)?<br />
		      Living costs are a minimum amount set for visa purposes. Living costs vary depending on where you will be living and studying. It is your responsibility to determine what your own costs will be to live and study in Australia. Even if you have permission to work you should not rely on work to support yourself in Australia as a student.<br />
		      <table width="100%">
                <tr>
                  <td width="15%"><input type="radio" name="rd_43" value="0" <?= (@$info->rd_43==0)?'checked':''?> />
                    No ▶ </td>
                  <td width="85%">Go to Question 44</td>
                </tr>
                <tr>
                  <td><input type="radio" name="rd_43" value="1" <?= (@$info->rd_43==1)?'checked':''?> />
                    Yes ▶</td>
                  <td valign="top">Please complete the declaration below <br />
                    If you are under 18 years of age, this declaration must be signed on your behalf by your parents or a person(s) who has legal custody of you.<br />
                    If you are in Assessment Level 2–5, you must provide documentary evidence that you have sufficient funds (unless you are a secondary school exchange student). It is important that you refer to the department’s website www.immi.gov.au/students/ for details regarding the level of funds you are required to demonstrate, acceptable sources of funds and of the length of time funds must have been held.<br />
                    I declare that I have access to sufficient funds to support myself and my family unit members (regardless of whether they are accompanying me to Australia) for the total period of my stay in Australia.<br /></td>
                </tr>
              </table></td>
		</tr>
		
		<tr class="even">
		    <td colspan="5"><strong>Additional information</strong></td>
		</tr>
		
		<tr class="odd">
		    <td colspan="5">44 If there is any other information or documentation you would like taken into consideration in assessing your application attach it to the application.<br />
		      Remember that a decision may be based solely on the information you provide in this application.<br />
		      Note: If you are applying in Australia as an Assessment Level 2–5 applicant and do not hold a student visa, you must provide exceptional reasons to justify the grant of your visa.<br />
	          ▶ ▶ Now go to Part D</td>
		</tr>
		
		<tr class="even">
		    <td colspan="5"><strong>Part C – To be completed only if you are a family unit member joining a student in Australia</strong></td>
		</tr>
		
		<tr class="odd">
		    <td colspan="2">45 Has the student you are joining, who is a member of your family unit,completed form 919 Nomination of student dependants?</td>
			<td colspan="3"><input type="radio" name="rd_45" value="0" <?= (@$info->rd_45==0)?'checked':''?> />
No ▶ If applying outside Australia, you must provide a completed form 919 with this application<br />
<input type="radio" name="rd_45" value="1" <?= (@$info->rd_45==1)?'checked':''?> />
Yes ▶ Attach the completed form 919 to this application</td>
		</tr>
		
		<tr class="even">
		    <td colspan="2">46 Do you intend to study in Australia for more than 3 months?</td>
			<td colspan="3"><input type="radio" name="rd_46" value="0" <?= (@$info->rd_46==0)?'checked':''?> />
No <br />
<input type="radio" name="rd_46" value="1" <?= (@$info->rd_46==1)?'checked':''?> />
Yes ▶ If you are 5 years up to 18 years of age, please provide documentary evidence of school enrolment in Australia. If you are 18 years of age or older and you intend to study in Australia for more than 3 months, you must apply for a student visa as a principal applicant, rather than as a family unit member.</td>
		</tr>
		
		<tr class="odd">
		    <td colspan="5">47 Provide details of the student you are joining in Australia<br />
		      Name 
		      <input type="text" name="txt_47_1" value="<?= @$info->txt_47_1?>"/>		      
		       Relationship to you 
	          <input type="text" name="txt_47_2" value="<?= @$info->txt_47_2?>"/>	          
	           <br />
	           Date of birth 
              <input type="text" name="txt_47_3" value="<?= @$info->txt_47_3?>" id="txt_47_3"/>
              
              Citizenship(s) 
              <input type="text" name="txt_47_4" value="<?= @$info->txt_47_4?>"/>              
               <br />
               Address 
              <input name="txt_47_5" type="text" value="<?= @$info->txt_47_5?>" style="width:300px"/>              
               POSTCODE 
              <input type="text" name="txt_47_6" value="<?= @$info->txt_47_6?>" style="width:50px"/>
              <br />
              Type of student visa held 
              <input type="text" name="txt_47_7" value="<?= @$info->txt_47_7?>"/>
              <br />
              What Assessment Level were they assessed against (if known)? 
              <input type="text" name="txt_47_8" value="<?= @$info->txt_47_8?>"/>
              <br />
              Date granted 
              <input type="text" name="txt_47_9" value="<?= @$info->txt_47_9?>" id="txt_47_9"/> 
              (DAY MONTH YEAR) &nbsp;&nbsp; <br />
              Expiry date 
              <input type="text" name="txt_47_10" value="<?= @$info->txt_47_10?>" id="txt_47_10"/>
(DAY MONTH YEAR)<br />
<br />
Note: You cannot join your family unit member in Australia on a student visa if they are in Assessment Levels 3–5 unless the total duration of the course(s) they are undertaking in Australia is at least 12 months or more.</td>
		</tr>
		
		<tr class="even">
		    <td colspan="2">48 Did the student you are joining declare in their initial student visa
		      application you and other members of their family unit included in this
		      application?</td>
			<td colspan="3"><input type="radio" name="rd_48" value="0" <?= (@$info->rd_48==0)?'checked':''?> />
No <br />
<input type="radio" name="rd_48" value="1" <?= (@$info->rd_48==1)?'checked':''?> />
Yes</td>
		</tr>
		
		<tr class="odd">
		    <td colspan="5">49 Is the student you are joining:<br />
		      • the holder of an International Postgraduate Research Scholarship;<br />
		      • sponsored by AusAID or the Australian Department of Defence;<br />
		      • fully sponsored by the federal, or a state or territory government of Australia;<br />
		      • fully sponsored by the government of your home country, or by a state or provincial government of your home country;<br />
		      • fully sponsored by a multilateral organisation eg. the United Nations, World Bank?<br />
		      <table width="100%">
                <tr>
                  <td width="15%"><input type="radio" name="rd_49" value="0" <?= (@$info->rd_49==0)?'checked':''?> />
No </td>
                  <td width="85%">&nbsp;</td>
                </tr>
                <tr>
                  <td><input type="radio" name="rd_49" value="1" <?= (@$info->rd_49==1)?'checked':''?> />
Yes ▶ </td>
                  <td valign="top">If the student you are joining is in Assessment Level 2–5 and was granted their visa after 1 December 2003, there are specific financial evidentiary requirements that you must meet. Please go to the department’s website for details on the levels of funds you are required to<br />
                    demonstrate, acceptable sources of funds and the length of time funds must be held.<br />
                    ▶▶Now go to Part D</td>
                </tr>
              </table></td>
		</tr>
		
		<tr class="even">
		    <td colspan="3">50 Does the student you are joining have sufficient funds to financially support themselves, you and any other family members included in this application, for the remainder of his or her stay in Australia?</td>
			<td colspan="2"><input type="radio" name="rd_50" value="0" <?= (@$info->rd_50==0)?'checked':''?> />
No <br />
<input type="radio" name="rd_50" value="1" <?= (@$info->rd_50==1)?'checked':''?> />
Yes ▶ You must attach evidence of this financial support</td>
		</tr>
		
		<tr class="odd">
		    <td colspan="5">Part D – To be completed by all applicants</td>
		</tr>
		
		<tr class="even">
		    <td colspan="5">Health declaration</td>
		</tr>
		
		<tr class="odd">
		    <td colspan="5">51 In the last 5 years, have you, or any other person included in this application, visited or lived outside your country of passport for more than 3 consecutive months?<br />
		      <table width="100%">
                <tr>
                  <td width="15%"><input type="radio" name="rd_51" value="0" <?= (@$info->sex==0)?'checked':''?> />
No </td>
                  <td width="85%">&nbsp;</td>
                </tr>
                <tr>
                  <td><input type="radio" name="rd_51" value="1" <?= (@$info->rd_51==1)?'checked':''?> />
Yes ▶ Give details</td>
                  <td>
1. Name
<input type="text" name="txt_51_1_1" value="<?= @$info->txt_51_1_1?>"/>
Country(s)
<input type="text" name="txt_51_1_2" value="<?= @$info->txt_51_1_2?>"/>
<br />
Date from
<input type="text" name="txt_51_1_3" value="<?= @$info->txt_51_1_3?>" id="txt_51_1_3"/>
(DAY MONTH YEAR) to
<input type="text" name="txt_51_1_4" value="<?= @$info->txt_51_1_4?>" id="txt_51_1_4"/>
(DAY MONTH YEAR) <br />
<br />
2. Name
<input type="text" name="txt_51_2_1" value="<?= @$info->txt_51_2_1?>"/>
Country(s)
<input type="text" name="txt_51_2_2" value="<?= @$info->txt_51_2_2?>"/>
<br />
Date from
<input type="text" name="txt_51_2_3" value="<?= @$info->txt_51_2_3?>" id="txt_51_2_3"/>
(DAY MONTH YEAR) to
<input type="text" name="txt_51_2_4" value="<?= @$info->txt_51_2_4?>" id="txt_51_2_4"/>
(DAY MONTH YEAR) <br />
<br />
3. Name
<input type="text" name="txt_51_3_1" value="<?= @$info->txt_51_3_1?>"/>
Country(s)
<input type="text" name="txt_51_3_2" value="<?= @$info->txt_51_3_2?>"/>
<br />
Date from
<input type="text" name="txt_51_3_3" value="<?= @$info->txt_51_3_3?>" id="txt_51_3_3"/>
(DAY MONTH YEAR) to
<input type="text" name="txt_51_3_4" value="<?= @$info->txt_51_3_4?>" id="txt_51_3_4"/>
(DAY MONTH YEAR) <br /></td>
                </tr>
              </table></td>
		</tr>
		
		<tr class="even">
		    <td colspan="2">52 Do you, or any other person included in this application, intend to enter a hospital or a health care facility (including nursing homes) while in Australia?</td>
			<td colspan="3"><input type="radio" name="rd_52" value="0" <?= (@$info->rd_52==0)?'checked':''?> />
No 
  <input type="radio" name="rd_52" value="1" <?= (@$info->rd_52==1)?'checked':''?> />
Yes ▶ Give details 
<textarea name="txt_52"><?= @$info->txt_52?></textarea></td>
		</tr>
		
		<tr class="odd">
		    <td colspan="2">53 Do you, or any other person included in this application, intend to work
		      as, or study to be, a doctor, dentist, nurse or paramedic during your
		      stay in Australia?</td>
			<td colspan="3"><input type="radio" name="rd_53" value="0" <?= (@$info->rd_53==0)?'checked':''?> />
No 
  <input type="radio" name="rd_53" value="1" <?= (@$info->rd_53==1)?'checked':''?> />
Yes ▶ Give details 
<textarea name="txt_53"><?= @$info->txt_53?></textarea></td>
		</tr>
		
		<tr class="even">
		    <td colspan="2">54 Do you, or any other person included in this application, intend to<br />
		      work, or be a trainee, at a child care centre (including preschools and<br />
		      creches) while in Australia?</td>
			<td colspan="3"><input type="radio" name="rd_54" value="0" <?= (@$info->rd_54==0)?'checked':''?> />
No 
  <input type="radio" name="rd_54" value="1" <?= (@$info->rd_54==1)?'checked':''?> />
Yes ▶ Give details 
<textarea name="txt_54"><?= @$info->txt_54?></textarea></td>
		</tr>
		
		<tr class="odd">
		    <td colspan="2">55 Have you, or any other person included in this application:<br />
		      • ever had, or currently have, tuberculosis?<br />
		      • been in close contact with a family member that has active tuberculosis?<br />
		      • ever had a chest x-ray which showed an abnormality?</td>
			<td colspan="3"><input type="radio" name="rd_55" value="0" <?= (@$info->rd_55==0)?'checked':''?> />
No 
  <input type="radio" name="rd_55" value="1" <?= (@$info->rd_55==1)?'checked':''?> />
Yes ▶ Give details 
<textarea name="txt_55"><?= @$info->txt_55?></textarea></td>
		</tr>
		
		<tr class="even">
		    <td colspan="2">56 During your proposed visit to Australia, do you, or any other person
		      included in this application, expect to incur medical costs, or require
		      treatment or medical follow up for:<br />
		      <table width="98%">
                <tr>
                  <td width="31%">• blood disorder;</td>
                  <td width="69%">• HIV infection, including AIDS;</td>
                </tr>
                <tr>
                  <td>• cancer;</td>
                  <td>• kidney disease, including dialysis;</td>
                </tr>
                <tr>
                  <td>• heart disease;</td>
                  <td>• pregnancy;</td>
                </tr>
                <tr>
                  <td>• mental illness;</td>
                  <td>• hepatitis B or C and/or liver disease;</td>
                </tr>
                <tr>
                  <td>• other?</td>
                  <td>• respiratory disease that has required<br />
                    hospital admission or oxygen therapy;</td>
                </tr>
              </table>
		      <br />
		      <br /></td>
			<td colspan="3" valign="top">
<input type="radio" name="rd_56" value="0" <?= (@$info->rd_56==0)?'checked':''?> />
No 
  <input type="radio" name="rd_56" value="1" <?= (@$info->rd_56==1)?'checked':''?> />
Yes ▶ Give details 

<textarea name="txt_56"><?= @$info->txt_56?></textarea>
<br />
<br />
You are strongly advised to carry certification of your vaccination status, especially for children attending Australian child care centres (including preschools and creches) and schools. Vaccination against polio,<br />
tetanus, measles, mumps, rubella, diphtheria, pertussis (whooping cough), Haemophilus influenzae hypo B (Hib), and Hepatitis B is recommended for children, with certification sought at time of child care centre (including preschool and creche) and school enrolment. Vaccination against rubella is also recommended for women of child bearing age.</td>
		</tr>
		
		<tr class="odd">
		    <td colspan="2">57 Do you, or any other person included in this application, require
		      assistance with mobility or care due to a medical condition?</td>
			<td colspan="3"><input type="radio" name="rd_57" value="0" <?= (@$info->rd_57==0)?'checked':''?> />
No 
  <input type="radio" name="rd_57" value="1" <?= (@$info->rd_57==1)?'checked':''?> />
Yes ▶ Give details <br />
<textarea name="txt_57"><?= @$info->txt_57?></textarea>
</td>
		</tr>
		
		<tr class="even">
		   <td colspan="5"><strong>Character declaration</strong></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">58 Have you, or any member of your family unit included in this application, ever:<br />
		     <table width="100%">
               <tr>
                 <td width="70%">• been convicted of a crime or offence in any country (including any conviction which is now removed from official records)?</td>
                 <td width="30%"><input type="radio" name="rd_58_1" value="0" <?= (@$info->rd_58_1==0)?'checked':''?> />
No
  <input type="radio" name="rd_58_1" value="1" <?= (@$info->rd_58_1==1)?'checked':''?> />
Yes</td>
               </tr>
               <tr>
                 <td>• been charged with any offence that is currently awaiting legal action?</td>
                 <td><input type="radio" name="rd_58_2" value="0" <?= (@$info->rd_58_2==0)?'checked':''?> />
No
  <input type="radio" name="rd_58_2" value="1" <?= (@$info->rd_58_2==1)?'checked':''?> />
Yes</td>
               </tr>
               <tr>
                 <td>• been acquitted of any criminal offence or other offence on the grounds of mental illness, insanity or unsoundness of mind?</td>
                 <td><input type="radio" name="rd_58_3" value="0" <?= (@$info->rd_58_3==0)?'checked':''?> />
No
  <input type="radio" name="rd_58_3" value="1" <?= (@$info->rd_58_3==1)?'checked':''?> />
Yes</td>
               </tr>
               <tr>
                 <td>• been removed or deported from any country (including Australia)?</td>
                 <td><input type="radio" name="rd_58_4" value="0" <?= (@$info->rd_58_4==0)?'checked':''?> />
No
  <input type="radio" name="rd_58_4" value="1" <?= (@$info->rd_58_4==1)?'checked':''?> />
Yes</td>
               </tr>
               <tr>
                 <td>• left any country to avoid being removed or deported?</td>
                 <td><input type="radio" name="rd_58_5" value="0" <?= (@$info->rd_58_5==0)?'checked':''?> />
No
  <input type="radio" name="rd_58_5" value="1" <?= (@$info->rd_58_5==1)?'checked':''?> />
Yes</td>
               </tr>
               <tr>
                 <td>• been excluded from or asked to leave any country (including Australia)?</td>
                 <td><input type="radio" name="rd_58_6" value="0" <?= (@$info->rd_58_6==0)?'checked':''?> />
No
  <input type="radio" name="rd_58_6" value="1" <?= (@$info->rd_58_6==1)?'checked':''?> />
Yes</td>
               </tr>
               <tr>
                 <td>• committed, or been involved in, the commission of war crimes or crimes against humanity or human rights?</td>
                 <td><input type="radio" name="rd_58_7" value="0" <?= (@$info->rd_58_7==0)?'checked':''?> />
No
  <input type="radio" name="rd_58_7" value="1" <?= (@$info->rd_58_7==1)?'checked':''?> />
Yes</td>
               </tr>
               <tr>
                 <td>• been involved in any activities that would represent a risk to Australian national security?</td>
                 <td><input type="radio" name="rd_58_8" value="0" <?= (@$info->rd_58_8==0)?'checked':''?> />
No
  <input type="radio" name="rd_58_8" value="1" <?= (@$info->rd_58_8==1)?'checked':''?> />
Yes</td>
               </tr>
               <tr>
                 <td>• had any outstanding debts to the Australian Government or any public authority in Australia?</td>
                 <td><input type="radio" name="rd_58_9" value="0" <?= (@$info->rd_58_9==0)?'checked':''?> />
No
  <input type="radio" name="rd_58_9" value="1" <?= (@$info->rd_58_9==1)?'checked':''?> />
Yes</td>
               </tr>
               <tr>
                 <td>• been involved in any activity, or been convicted of any offence, relating to the illegal movement of people to any country (including Australia)?</td>
                 <td><input type="radio" name="rd_58_10" value="0" <?= (@$info->rd_58_10==0)?'checked':''?> />
No
  <input type="radio" name="rd_58_10" value="1" <?= (@$info->rd_58_10==1)?'checked':''?> />
Yes</td>
               </tr>
               <tr>
                 <td>• served in a military force or state sponsored/private militia, undergone any military/paramilitary training, or been trained in weapons/explosives use (however described)?</td>
                 <td><input type="radio" name="rd_58_11" value="0" <?= (@$info->rd_58_11==0)?'checked':''?> />
No
  <input type="radio" name="rd_58_11" value="1" <?= (@$info->rd_58_11==1)?'checked':''?> />
Yes</td>
               </tr>
             </table>
		     <br />
		     If you answered ‘Yes’ to any of the above questions, you must state who it applies to and give ALL relevant details. If the matter relates to a criminal conviction, please give the nature of the offence, full details of sentence and dates of any period of imprisonment or other detention. If insufficient space, attach an additional statement.<br />
		     <textarea name="txt_58"><?= @$info->txt_58?></textarea>
		     </td>
		</tr>
		
		<tr class="even">
		   <td colspan="5"><strong>Accommodation/welfare arrangements for students under 18 years of age</strong></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5" valign="top">59 Are you under 18 years of age?<br />
		     Note: Depending on your Assessment Level, you may need to meet a minimum age or education standard requirement. Refer to information form 1219i Overseas Student Program – Assessment Levels and the department’s website for more details.<br />
		     <table width="100%">
               <tr>
                 <td width="15%"><input type="radio" name="rd_59" value="0" <?= (@$info->rd_59==0)?'checked':''?> />
No  ▶ </td>
                 <td width="85%">Go to Question 69</td>
               </tr>
               <tr>
                 <td><input type="radio" name="rd_59" value="1" <?= (@$info->rd_59==1)?'checked':''?> />
Yes  ▶ </td>
                 <td>Questions 60 (and either Question 61, 62, 64 or 65) and the declaration at 66 must be completed on your behalf by your parents or a person(s) who has legal custody of you, as you are under 18 years of age. If your parents or a person(s) who has legal custody of you have not made adequate arrangements for your accommodation, support and general welfare while in Australia, a student visa cannot be granted. Evidence of their relationship to you must be provided.</td>
               </tr>
             </table>
		    
		     </td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">60 This question, and other questions as indicated, must be completed by the parents, or person(s) who has legal custody of the applicant under 18 years of age.<br />
		     Which statement best explains your situation?<br />
		     <table width="100%">
               <tr>
                 <td width="70%"><input type="radio" name="rd_60" value="1" <?= (@$info->rd_60==1)?'checked':''?> />
                   I am a parent or person who has legal custody of the student applicant and I am going to accompany the child to Australia. </td>
                 <td width="30%">▶ Go to Question 61</td>
               </tr>
               <tr>
                 <td><input type="radio" name="rd_60" value="2" <?= (@$info->rd_60==2)?'checked':''?> />
                   I am a parent or person who has legal custody of the student applicant and have made arrangements for the child to stay in Australia with a relative* who is 21 years of age or older. <br />* A relative is defined under the Migration Regulations as a
spouse, de facto partner, child, parent, brother, sister, step-child,
step-parent, step-brother, step-sister, grandparent, grandchild, aunt,
uncle, niece or nephew, or a step-grandparent, step-grandchild,
step-aunt, step-uncle, step-niece or step-nephew.</td>
                 <td>▶ Go to Question 62</td>
               </tr>
               <tr>
                 <td><input type="radio" name="rd_60" value="3" <?= (@$info->rd_60==3)?'checked':''?> />
                   The student applicant will not be accompanied by either a parent or a person who has legal custody, and will
                   not stay in Australia with a relative who
                   is 21 years of age or older. </td>
                 <td>▶ Go to Question 65</td>
               </tr>
             </table></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">61 As the parent or a person who has legal custody of a student applicant under 18 years of age, do you hold or have you applied for a visa (eg. Student Guardian visa – subclass 580) to accompany your child during their stay in Australia?<br />
		       <table width="100%">
                 <tr>
                   <td width="15%"><input type="radio" name="rd_61" value="0" <?= (@$info->rd_61==0)?'checked':''?> />
                    No </td>
                   <td width="85%">&nbsp;</td>
                 </tr>
                 <tr>
                   <td><input type="radio" name="rd_61" value="1" <?= (@$info->rd_61==1)?'checked':''?> />
                    Yes ▶</td>
                   <td>Please give your details below, then go to Question 66<br />
Family name
  <input type="text" name="txt_61_1" value="<?= @$info->txt_61_1?>"/>
Given names
<input type="text" name="txt_61_2" value="<?= @$info->txt_61_2?>"/>
Date of birth
<input type="text" name="txt_61_3" value="<?= @$info->txt_61_3?>" id="txt_61_3"/>
<br />
Your intended address in Australia
<input name="txt_61_4" type="text" value="<?= @$info->txt_61_4?>" style="width:300px"/>
POSTCODE
<input type="text" name="txt_61_5" value="<?= @$info->txt_61_5?>" style="width:50px"/>
<br />
Application:<br />
<table width="100%">
  <tr>
    <td width="20%"><input type="radio" name="rd_61_6" value="1" <?= (@$info->rd_61_6==1)?'checked':''?> />
      Granted ▶</td>
    <td width="80%">Visa label number
      <input type="text" name="txt_61_7" value="<?= @$info->txt_61_7?>"/>
      <br />
      If granted a visa without a label, provide the 13-digit visa grant number (as shown on the letter notifying you of visa grant).
      <input type="text" name="txt_61_8" value="<?= @$info->txt_61_8?>"/>
      <br />
      Period of stay
      <input type="text" name="txt_61_9" value="<?= @$info->txt_61_9?>"/>
      MONTHS &nbsp;&nbsp;&nbsp;Expiry date
      <input type="text" name="txt_61_10" value="<?= @$info->txt_61_10?>" id="txt_61_10"/></td>
  </tr>
  <tr>
    <td><input type="radio" name="rd_61_6" value="2" <?= (@$info->rd_61_6==2)?'checked':''?> />
      Not yet decided ▶</td>
    <td>Australian Government office where application lodged
      <input name="txt_61_11" type="text" value="<?= @$info->txt_61_11?>"/></td>
  </tr>
</table>
▶▶Now go to Question 66</td>
                 </tr>
               </table>
              </td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">62 As the parents or a person(s) who has legal custody of a student applicant under 18 years of age, have you made arrangements with a relative who is at least 21 years of age and of good character with whom your child will stay in Australia?<br />
		     <table width="100%">
               <tr>
                 <td width="15%"><input type="radio" name="rd_62" value="0" <?= (@$info->rd_62==0)?'checked':''?> />
                   No </td>
                 <td width="85%">&nbsp;</td>
               </tr>
               <tr>
                 <td><input type="radio" name="rd_62" value="1" <?= (@$info->rd_62==1)?'checked':''?> />
                   Yes ▶</td>
                 <td>Please give details of the relative<br />
                   Family name
                   <input type="text" name="txt_62_1" value="<?= @$info->txt_62_1?>"/>
                   Given names
                   <input type="text" name="txt_62_2" value="<?= @$info->txt_62_2?>"/>
                   <br />
                   Date of birth
                   <input type="text" name="txt_62_3" value="<?= @$info->txt_62_3?>" id="txt_62_3"/>
                   <br />
                   Address of relative in Australia
                   <input name="txt_62_4" type="text" value="<?= @$info->txt_62_4?>" style="width:300px"/>
                   <br />
                   POSTCODE
                   <input type="text" name="txt_62_5" value="<?= @$info->txt_62_5?>" style="width:50px"/>
                   <br />
                   Relationship of relative to the child 
                   <input type="text" name="txt_62_6" value="<?= @$info->txt_62_6?>"/></td>
               </tr>
             </table></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">63 Will your relative reside in Australia as:<br />
		     <table width="100%">
               <tr>
                 <td width="30%"><input type="radio" name="rd_63" value="1" <?= (@$info->rd_63==1)?'checked':''?> />
                   an Australian citizen or
                   permanent resident</td>
                 <td width="70%">&nbsp;</td>
               </tr>
               <tr>
                 <td><input type="radio" name="rd_63" value="2" <?= (@$info->rd_63==2)?'checked':''?> />
                   a Temporary resident ▶</td>
                 <td valign="top">How long are they permitted to stay in Australia? <br />
                 <input type="text" name="txt_63_1" value="<?= @$info->txt_63_1?>"/>                   
                 	OR until 
                 	<input type="text" name="txt_63_2" value="<?= @$info->txt_63_2?>" id="txt_63_2"/></td></tr>
             </table>
		     
		     Form 157N must be completed and lodged together with this application.</td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">64 Give details of your relative’s Student Guardian visa application<br />
		     <table width="100%">
               <tr>
                 <td width="20%"><input type="radio" name="rd_64" value="1" <?= (@$info->rd_64==1)?'checked':''?> />
                   Granted ▶</td>
                 <td width="80%">Visa label number
                   <input type="text" name="txt_64_1" value="<?= @$info->txt_64_1?>"/>
                   <br />
                   Period of stay
                   <input type="text" name="txt_64_2" value="<?= @$info->txt_64_2?>"/>
                   MONTHS &nbsp;&nbsp;&nbsp;Expiry date
                   <input type="text" name="txt_64_3" value="<?= @$info->txt_64_3?>" id="txt_64_3"/></td>
               </tr>
               <tr>
                 <td><input type="radio" name="rd_64" value="2" <?= (@$info->rd_64==2)?'checked':''?> />
                   Not yet decided ▶</td>
                 <td>Australian Government office where application lodged
                   <input name="txt_64_4" type="text" value="<?= @$info->txt_64_4?>" />
                   <br />
                   Period of stay sought 
                   <input type="text" name="txt_64_5" value="<?= @$info->txt_64_5?>"/>
MONTHS </td>
               </tr>
             </table>
		     ▶▶Now go to Question 66</td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">65 As the parents or a person(s) who has legal custody of a student applicant under 18 years of age, who is neither being accompanied by
		     you nor staying with a relative who is at least 21 years of age, have you
		     obtained a written statement from your child’s education provider(s)
		     that accommodation, support and general welfare arrangements for
		     your child are appropriate?<br />
		     <input type="radio" name="rd_65" value="0" <?= (@$info->rd_65==0)?'checked':''?> />		     
		      No 
		      <input type="radio" name="rd_65" value="1" <?= (@$info->rd_65==1)?'checked':''?> />
Yes  ▶ Please attach the original or a copy of the signed undertaking from the education provider</td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">66 I am satisfied with the reception, care and support arrangements that have been made in Australia for my dependent child under 18 years of age.<br />
		     Note: Both parents must sign this declaration.<br />
		      Full name (print in English) 
		      <input type="text" name="txt_66_1" value="<?= @$info->txt_66_1?>"/>		      
		       Relationship to student applicant 
	          <input type="text" name="txt_66_2" value="<?= @$info->txt_66_2?>"/>
	          <br />
	          <br />
Full name (print in English)
<input type="text" name="txt_66_3" value="<?= @$info->txt_66_3?>"/>
Relationship to student applicant
<input type="text" name="txt_66_4" value="<?= @$info->txt_66_4?>"/></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5"><strong>Custody arrangements for students under 18 years of age</strong></td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">67 Do you have the sole legal right to determine where the applicant will live or to remove the applicant from their country of usual residence?<br />
		     <table width="100%">
               <tr>
                 <td width="10%"><input type="radio" name="rd_67" value="0" <?= (@$info->rd_67==0)?'checked':''?> />
                   No ▶</td>
                 <td width="90%" valign="top">Provide details of ALL other people who have custody, access or guardianship rights in relation to the applicant<br />
                   If there is more than one person, please attach details.<br />
                   Name 
                   <input type="text" name="txt_67_1" value="<?= @$info->txt_67_1?>"/>                   
                    <br />
                    Residential address 
                    <input name="txt_67_2" type="text" value="<?= @$info->txt_67_2?>" style="width:300px"/>                    
                     POSTCODE  <input type="text" name="txt_67_3" value="<?= @$info->txt_67_3?>" style="width:50px"/>
                     <br />
                     Telephone number : COUNTRY CODE 
                     <input name="txt_67_4" type="text" value="<?= @$info->txt_67_4?>" style="width:50px"/>
                      AREA CODE 
                      <input name="txt_67_5" type="text" value="<?= @$info->txt_67_5?>" style="width:50px"/>
                     NUMBER 
                     <input type="text" name="txt_67_6" value="<?= @$info->txt_67_6?>"/>
                     <br />
                     Relationship to student visa applicant 
                     <input type="text" name="txt_67_7" value="<?= @$info->txt_67_7?>"/>                     
                      Nature of legal right 
                     <input type="text" name="txt_67_8" value="<?= @$info->txt_67_8?>"/>
                     <br />
                     You must sign the declaration at Question 68. All other people who have custody, access or guardianship rights in relation to the applicant must also sign the declaration at Question 68. <br />
                     If any of these people are unable to complete the declaration at Question 68 for any reason, you must attach a statutory declaration from them giving permission for the applicant to travel to Australia as a student.</td>
               </tr>
               <tr>
                 <td><input type="radio" name="rd_67" value="1" <?= (@$info->rd_67==1)?'checked':''?> />
                   Yes ▶</td>
                 <td>Complete the declaration at Question 68</td>
               </tr>
             </table></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">68 Declaration by the parent(s) or person(s) with legal custody of a student visa applicant under 18 years of age<br />
		     I am not aware of any reason why the visa applicant should not travel to Australia (the custody/access/guardianship rights of another person are not affected).
		     <br />
		      Full name (print in English) 
		      <input type="text" name="txt_68_1" value="<?= @$info->txt_68_1?>"/>		      
		       Relationship to student applicant 
	          <input type="text" name="txt_68_2" value="<?= @$info->txt_68_2?>"/>
	          <br />
	          <br />
Full name (print in English)
<input type="text" name="txt_68_3" value="<?= @$info->txt_68_3?>"/>
Relationship to student applicant
<input type="text" name="txt_68_4" value="<?= @$info->txt_68_4?>"/>
<br />
<br />
If more than 2 people have custody, access or guardianship rights in relation to the applicant, please attach a statutory declaration from them giving permission for the applicant to travel to Australia as a student.</td>
		</tr>
		
		<tr class="even">
		   <td colspan="5"><strong>Assistance with this form</strong></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">69 Did you receive assistance in completing this form?<br />
		     <table width="100%">
               <tr>
                 <td width="10%"><input type="radio" name="rd_69" value="0" <?= (@$info->rd_69==0)?'checked':''?> />
                   No ▶</td>
                 <td width="90%">Go to Question 74</td>
               </tr>
               <tr>
                 <td><input type="radio" name="rd_69" value="1" <?= (@$info->rd_69==1)?'checked':''?> />
                   Yes ▶</td>
                 <td>Please give details of the person who assisted you<br />
Title: 
<input type="radio" name="rd_69_1" value="1" <?= (@$info->rd_69_1==1)?'checked':''?> />
Mr 
<input type="radio" name="rd_69_1" value="2" <?= (@$info->rd_69_1==2)?'checked':''?> />
Mrs 
<input type="radio" name="rd_69_1" value="3" <?= (@$info->rd_69_1==3)?'checked':''?> />
Miss 
<input type="radio" name="rd_69_1" value="4" <?= (@$info->rd_69_1==4)?'checked':''?> />
Ms 
 
Other 
<input type="text" name="txt_69_2" value="<?= @$info->txt_69_2?>"/>
<br />
Family name 
<input type="text" name="txt_69_3" value="<?= @$info->txt_69_3?>"/> 
Given names 
<input type="text" name="txt_69_4" value="<?= @$info->txt_69_4?>"/>
<br />
Address 
<input name="txt_69_5" type="text" value="<?= @$info->txt_69_5?>" style="width:300px"/> 
POSTCODE 
<input type="text" name="txt_69_6" value="<?= @$info->txt_69_6?>" style="width:50px"/>
<br />
Telephone number or daytime contact <br />
Office hours: COUNTRY CODE 
                     <input name="txt_69_7" type="text" value="<?= @$info->txt_69_7?>" style="width:50px"/>
AREA CODE
<input name="txt_69_8" type="text" value="<?= @$info->txt_69_8?>" style="width:50px"/>
NUMBER
<input type="text" name="txt_69_9" value="<?= @$info->txt_69_9?>"/>
<br />
Mobile/cell 
<input type="text" name="txt_69_10" value="<?= @$info->txt_69_10?>"/></td>
               </tr>
             </table></td>
		</tr>
		
		<tr class="even">
		   <td colspan="2">70 Is the person an agent registered with the Office of the Migration Agents Registration Authority (Office of the MARA)?</td>
		    <td colspan="3"> <input type="radio" name="rd_70" value="0" <?= (@$info->rd_70==0)?'checked':''?> />
No 
<input type="radio" name="rd_70" value="1" <?= (@$info->rd_70==1)?'checked':''?> />
Yes ▶Go to Question 74</td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">71 Is the person an education agent?<br />
		     <table width="100%">
               <tr>
                 <td width="10%"><input type="radio" name="rd_71" value="0" <?= (@$info->rd_71==0)?'checked':''?> />
                   No </td>
                 <td width="90%">&nbsp;</td>
               </tr>
               <tr>
                 <td><input type="radio" name="rd_71" value="1" <?= (@$info->rd_71==1)?'checked':''?> />
                   Yes ▶</td>
                 <td>Please give details below<br />
                   Education Agency Business Name 
                     <input type="text" name="txt_71_1" value="<?= @$info->txt_71_1?>"/>
                     <br />
                     Education Agent Registration Number (if known) <input type="text" name="txt_71_2" value="<?= @$info->txt_71_2?>"/>
                     <br />
Address (if different from address given in Question 69) <br />
<input name="txt_71_3" type="text" value="<?= @$info->txt_71_3?>" style="width:300px"/>
POSTCODE
<input type="text" name="txt_71_4" value="<?= @$info->txt_71_4?>" style="width:50px"/>
<br />
                   E-mail address
                   <input type="text" name="txt_71_5" value="<?= @$info->txt_71_5?>"/>
                   <br />
                   Telephone number or daytime contact<br />
                   Office hours: COUNTRY CODE
                   <input name="txt_71_6" type="text" value="<?= @$info->txt_71_6?>" style="width:50px"/>
                   AREA CODE
                   <input name="txt_71_7" type="text" value="<?= @$info->txt_71_7?>" style="width:50px"/>
                   NUMBER
                   <input type="text" name="txt_71_8" value="<?= @$info->txt_71_8?>"/>
                   <br />
                   Mobile/cell
                   <input type="text" name="txt_71_9" value="<?= @$info->txt_71_9?>"/>
                   <br />
                   Fax number: COUNTRY CODE
                   <input name="txt_71_10" type="text" value="<?= @$info->txt_71_10?>" style="width:50px"/>
AREA CODE
<input name="txt_71_11" type="text" value="<?= @$info->txt_71_11?>" style="width:50px"/>
NUMBER
<input type="text" name="txt_71_12" value="<?= @$info->txt_71_12?>"/></td>
               </tr>
             </table></td>
		</tr>
		
		<tr class="even">
		   <td colspan="2">72 Is the person/agent in Australia?</td>
		   <td colspan="3"><input type="radio" name="rd_72" value="0" <?= (@$info->rd_72==0)?'checked':''?> />
No
  ▶Go to Question 74
  <input type="radio" name="rd_72" value="1" <?= (@$info->rd_72==1)?'checked':''?> />
Yes </td>
		</tr>
		
		<tr class="odd">
		   <td colspan="2">73 Did you pay the person/agent and/or give a gift for this assistance?</td>
		   <td colspan="3"><input type="radio" name="rd_73" value="0" <?= (@$info->rd_73==0)?'checked':''?> />
No
   
  <input type="radio" name="rd_73" value="1" <?= (@$info->rd_73==1)?'checked':''?> />
Yes </td>
		</tr>
		
		<tr class="even">
		   <td colspan="5"><strong>Options for receiving written communications</strong></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">74 All written communications about this application should be sent to: (Tick one box only)<br />
<input type="radio" name="rd_74" value="1" <?= (@$info->rd_74==1)?'checked':''?> />
Myself <br />
<input type="radio" name="rd_74" value="2" <?= (@$info->rd_74==2)?'checked':''?> />
Authorised recipient
▶ You should complete form 956A Appointment or withdrawal of an authorised recipient
<br />
<input type="radio" name="rd_74" value="3" <?= (@$info->rd_74==3)?'checked':''?> />
Migration agent 
<input type="radio" name="rd_74" value="4" <?= (@$info->rd_74==4)?'checked':''?> />
Exempt person ▶ Your migration agent/exempt person should complete form 956 Advice by a migration agent/exempt person of providing immigration assistance</td>
		</tr>
		
		<tr class="even">
		   <td colspan="5"><strong>Payment details</strong></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">75 How will you pay your application charge? If applying in Australia, debit card or credit card are the preferred methods of payment. Debit cards cannot be used for applications<br />
		     lodged by mail. If paying by bank cheque or money order please make payable to the Department of Immigration and Citizenship.<br />
		     If applying outside Australia, please check with the Australian Government office where you intend to lodge your application as to what methods of payment and currencies they can accept and to whom the payment should be made payable.<br />
		     <table width="100%">
               <tr>
                 <td width="15%"><input type="radio" name="rd_75" value="1" <?= (@$info->rd_75==1)?'checked':''?> />
                   Bank cheque </td>
                 <td width="85%">&nbsp;</td>
               </tr>
               <tr>
                 <td><input type="radio" name="rd_75" value="2" <?= (@$info->rd_75==2)?'checked':''?> />
                   Money order</td>
                 <td>&nbsp;</td>
               </tr>
               <tr>
                 <td><input type="radio" name="rd_75" value="3" <?= (@$info->rd_75==3)?'checked':''?> />
Debit card ▶</td>
                 <td>Cannot be used for applications lodged by mail</td>
               </tr>
               <tr>
                 <td><input type="radio" name="rd_75" value="4" <?= (@$info->rd_75==4)?'checked':''?> />
Credit card ▶</td>
                 <td>Give details below<br />
                   Payment by (tick one box): 
                   <input type="radio" name="rd_75_1" value="1" <?= (@$info->rd_75_1==1)?'checked':''?> />
                   MasterCard 
                   <input type="radio" name="rd_75_1" value="2" <?= (@$info->rd_75_1==2)?'checked':''?> />
				   American Express
				   <input type="radio" name="rd_75_1" value="3" <?= (@$info->rd_75_1==3)?'checked':''?> />
					Visa 
					<input type="radio" name="rd_75_1" value="4" <?= (@$info->rd_75_1==4)?'checked':''?> />
					Diners Club 
					<input type="radio" name="rd_75_1" value="5" <?= (@$info->rd_75_1==5)?'checked':''?> />
					JCB<br />
Australian Dollars 

: AUD <input type="text" name="txt_75_2" value="<?= @$info->txt_75_2?>"/> 
<br />
Credit card number 
<input type="text" name="txt_75_3" value="<?= @$info->txt_75_3?>"/>
<br />
Expiry date: 
<input name="txt_75_4" type="text" value="<?= @$info->txt_75_4?>" style="width:50px"/> 
MONTH /  
<input name="txt_75_5" type="text" value="<?= @$info->txt_75_5?>" style="width:50px"/>
YEAR &nbsp;&nbsp;&nbsp;<br />
Cardholder’s name 
<input type="text" name="txt_75_6" value="<?= @$info->txt_75_6?>"/>
<br />
Telephone number :  COUNTRY CODE
<input name="txt_75_7" type="text" value="<?= @$info->txt_75_7?>" style="width:50px"/>
AREA CODE
<input name="txt_75_8" type="text" value="<?= @$info->txt_75_8?>" style="width:50px"/>
NUMBER
<input type="text" name="txt_75_9" value="<?= @$info->txt_75_9?>"/>
<br />
Address 
<input type="text" name="txt_75_10" value="<?= @$info->txt_75_10?>" style="width:300px"/>
POSTCODE
<input type="text" name="txt_75_11" value="<?= @$info->txt_75_11?>" style="width:50px"/>
<br />
<br />
Credit card information will be used for charge paying purposes only.</td>
               </tr>
             </table></td>
		</tr>
    </tbody>
	</table>
<!-- table end -->
</form>

			</div>
		</div>
		
		<?=$this->load->view('include_sidebar',array('id'=>$id,'forms'=>$forms))?>
	</div>

<script type="text/javascript">
$().ready(function() {
	$("#form").validate({
		rules: {
			txt_1:"required",
			rd_2:"required",
			surname:"required",
			firstname:"required",
			birth:"required",
			birth_place:"required",
			birth_country:"required",
			marital_status:"required"
		}
	});
  
	$.datepicker.setDefaults(
		{
		dateFormat: 'dd/mm/yy',
		changeMonth: true,
		changeYear: true,
		showOn: "both",
		buttonImage: "images/calendar.gif",
		buttonImageOnly: true
		}
	);

	$("#birth").datepicker();
	$("#travel_document_issue_date").datepicker();
	$("#travel_document_valid_date").datepicker();
	$("#member1_birth").datepicker();
	$("#member1_issue").datepicker();
	$("#member1_expiry").datepicker();
	$("#member2_birth").datepicker();
	$("#member2_issue").datepicker();
	$("#member2_expiry").datepicker();
	$("#member3_birth").datepicker();
	$("#member3_issue").datepicker();
	$("#member3_expiry").datepicker();
	$("#pre1_date").datepicker();
	$("#pre2_date").datepicker();
	$("#txt_28").datepicker();
	$("#txt_29").datepicker();
	$("#qualification1_startdate").datepicker();
	$("#qualification1_enddate").datepicker();
	$("#qualification2_startdate").datepicker();
	$("#qualification2_enddate").datepicker();
	$("#qualification3_startdate").datepicker();
	$("#qualification3_enddate").datepicker();
	$("#intended1_from").datepicker();
	$("#intended1_to").datepicker();
	$("#intended2_from").datepicker();
	$("#intended2_to").datepicker();
	$("#intended3_from").datepicker();
	$("#intended3_to").datepicker();
	$("#txt_35_2").datepicker();
	$("#relative1_birth").datepicker();
	$("#relative1_arrival_date").datepicker();
	$("#relative2_birth").datepicker();
	$("#relative2_arrival_date").datepicker();
	$("#txt_47_3").datepicker();
	$("#txt_47_9").datepicker();
	$("#txt_47_10").datepicker();
	$("#txt_51_1_3").datepicker();
	$("#txt_51_1_4").datepicker();
	$("#txt_51_2_3").datepicker();
	$("#txt_51_2_4").datepicker();
	$("#txt_51_3_3").datepicker();
	$("#txt_51_3_4").datepicker();
	$("#txt_61_3").datepicker();
	$("#txt_61_10").datepicker();
	$("#txt_62_3").datepicker();
	$("#txt_63_2").datepicker();
	$("#txt_64_3").datepicker();
	
	$("#email").autoMail();
	

	$("#printInfo").click(function(o) {
		var prints = [
			{rel_id: <?=$cateid?>, rec_id: <?=$id?>}
		]  ;
		
		var jdata = JSON.stringify(prints);
		//alert(jdata);
		$.post("<?=site_url('proxy/does/'.str_replace('==','',base64_encode('http://'.$_SERVER['SERVER_NAME'].':9090/javaprduct/servlet/test')))?>",{clients:jdata},function(msg){alert(msg)});
	});
	
	$("#printInfo").ajaxError(function(event,request, settings){
		//$(this).append("<li>出错页面:" + settings.url + "</li>");
		alert("无法访问"+ settings.url );
	}); 
 
});
</script>

<?=$this->load->view('include_footer',null)?>